Document Detail


Rationale, design and baseline characteristics of the PRO-TECT II study: PROpofol CardioproTECTion for Type II diabetics: a randomized, controlled trial of high-dose propofol versus isoflurane preconditioning in patients undergoing on-pump coronary artery bypass graft surgery.
MedLine Citation:
PMID:  19336262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diabetes mellitus is a leading cause of death globally and results in significant morbidity and mortality following surgery. After cardiac surgery, diabetic patients are especially at risk for low cardiac output syndrome, which can quadruple the risk for postoperative death. Attempts to prevent low cardiac output syndrome have focused on increasing myocardial tolerance to ischemia (preconditioning), which involves the myocardial mitochondrial ATP-regulated K(ATP) channel, G-protein initiation, nitric oxide synthase, and protein kinase C. Unfortunately, the signal transduction pathways required for preconditioning are corrupted in diabetes. Effective antioxidant intervention during ischemia-reperfusion appears important for preserving myocardial function; thus, alleviating oxidant-mediated post-ischemic injury by increasing antioxidant defenses (cardioprotection) is an alternative to preconditioning. Our previous work suggests that propofol (2,6-diisopropylphenol), an intravenous anesthetic with antioxidant potential, may confer cardioprotection. In this paper, we describe the rationale and methodology of the Pro-TECT II Study, a Phase II randomized controlled trial designed to explore the relationships of biomarkers of oxidative or nitrosative stress in diabetes, to determine the effect of propofol cardioprotection to counteract these effects in patients undergoing elective primary coronary bypass graft surgery with cardiopulmonary bypass, and to provide feasibility and sample size data needed to conduct Phase III trials.
Authors:
David M Ansley; Koen Raedschelders; David D Y Chen; Peter T Choi
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-03-29
Journal Detail:
Title:  Contemporary clinical trials     Volume:  30     ISSN:  1559-2030     ISO Abbreviation:  -     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-05-18     Completed Date:  2009-09-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101242342     Medline TA:  Contemp Clin Trials     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada. david.ansley@vch.ca
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation*
Anesthetics, Intravenous / administration & dosage*
Cardiovascular Diseases / epidemiology*,  surgery*
Coronary Artery Bypass / methods*
Coronary Artery Bypass, Off-Pump / methods*
Diabetes Mellitus, Type 2 / epidemiology*
Female
Humans
Ischemic Preconditioning, Myocardial / methods*
Isoflurane / administration & dosage*
Male
Middle Aged
Propofol / administration & dosage*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 2078-54-8/Propofol; 26675-46-7/Isoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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